Episode 36 - Which supplements can help in HA recovery?

In this episode, Nicola and Florence talk about evidence-based supplements to support your recovery...and those who are not at all helpful.

To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre
To join the NPNW English support group, please visit noperiod.info/support
To join the French support group, please visit noperiod.info/communaute
To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media
No Period, Now What? on Instagram in English
No Period, Now What? on Instagram in French
Beyond Body Image on Facebook
Beyond Body Image on Instagram

Email us  via allin@noperiodnowwhat.com

If you enjoyed this podcast and found it helpful, please drop us a rating and a review to help more people find it. 

Original Music by the Andy Shulman Band "Lost & Found" available on Spotify. 

To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre
To join the NPNW English support group, please visit noperiod.info/support
To join the French support group, please visit noperiod.info/communaute
To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media
No Period, Now What? on Instagram in English
No Period, Now What? on Instagram in French
Beyond Body Image on Facebook
Beyond Body Image on Instagram

Email us via allin@noperiodnowwhat.com

If you enjo...

Transcript

0:13

Welcome to All In, a straight shooting, science based podcast about periods, fertility, and nurturing health outside of unrealistic beauty expectations. We will mostly, but not exclusively, focus on hypothalamic amenorrhea, HA, a component of relative energy deficiency in sport, formerly known as the female athlete triad. I'm Dr. Nicola Sykes, scientist and author of the book No Period, Now What? I specialize in helping people understand how their eating, exercise, and lifestyle habits are keeping them from hormonal health and their best life. My work focuses on regaining periods, improving fertility, and breaking free of the rules underlying diet culture. My name is Florence Gillet. I'm a certified eating psychology coach, a former HA patient, and an advocate of health at every size and body neutrality. I help people let go of their obsession with size and appearance to regain self confidence, finally appreciate their bodies, and live an overall fuller, more joyful life. Every two weeks, the All In podcast brings you real recovery stories, expert insights, and new scientific research on HA, hormonal health and fertility, with an unmissable touch of body respect and women's empowerment. Just a reminder that this podcast represents the opinions of the hosts and their guests. This content should not be taken as medical advice, it's for informational purposes only. And because each person is unique, please consult your primary care practitioner for any medical questions. Music by the Andy Shulman Band, available on Spotify.

Florence: 1:51

Welcome everyone to this second episode of the mini episodes we have planned for you this summer. Hi, Nicola. How are you?

Nicola: 1:59

I'm doing well, thanks. I have one of my two identical black cats climbing around me right now, so their actual names are Midnight and Mystic, but we also joke that there's Midtick and Miss Night, because we don't know which is which. So one of them, one of them is climbing on my lap right now. So yeah, I just wanted to do a quick little thing about different supplements that people are sometimes recommended for getting their period back. So there are some things that there's some evidence of actual viability of where, you know, that they actually work. And there are a lot of things that people are recommended that are just like, Why what's the mechanism? What's the rationale for doing this besides making somebody lots of money. So do you have any that you wanted to start with or I did a post in my support group and I got some good suggestions from there of things to talk about

Florence: 2:52

Well, I usually recommend the ones that are in the book that are the most proven ones, you know, and, I do tell people that it has to go hand in hand with re nourishing and resting and all of that stuff. Because a lot of ladies have told me they had tried those being undernourished but obviously it doesn't do much. But it's the Acetyl L carnitine and then Gosh, I lost it. Milled flax seeds?.

Nicola: 3:19

Yes. Which is also called linseeds

Florence: 3:20

those two I

Nicola: 3:22

so that that is the same thing. So I was actually just rereading my blog post on the acetyl L carnitine because I've been recommending it to people for so long I kind of forget like why it

Florence: 3:32

about that.

Nicola: 3:33

Yes, yes, so that one has actually been used in three clinical studies in women with HA and there's an increased recovery rate in all of the studies. They did hormonal testing They looked at things like LH levels after some number of months of taking it They found that there was an increased rate of period recovery and you know, it is a chemical that crosses the blood brain barrier. So, you know, it mechanistically makes sense that, you know, it getting to your hypothalamus, it could be having some effect there. The fact that there are three clinical studies, I mean, they are all done by the same group. So, you know, a little bit of caveat there, but, they were in three different decades.

Florence: 4:13

And can I just say something? A lot of people, they believe that sometimes, the carnitine supplement is used to lose weight. And that sometimes confuses people why we would recommend something that seems very similar to that supplement that is sometimes used in kind of, you know, dieting or fitness culture. So maybe you can say something about the difference between what we recommend and the carnitine one.

Nicola: 4:44

well, so it's actually interesting. There's not really any evidence that it causes weight loss. So it's like a thing that people say, but it's not actually supported by evidence or

Florence: 4:55

culture What do you mean a supplement sold by diet culture that is not working? What? Shock horror.

Nicola: 5:05

Placebos are magical. I mean, you know, I started on Zoloft last year when I was struggling with everything with my family and all of that. And I took a teeny tiny dose. I like, I, I took the lowest dose and I cut the pills in half. And I felt better almost immediately. I was like, Placebos are great.

Florence: 5:25

It's, it's totally that. So you could, you could buy that stuff and feel great. And it's actually not doing much, but yeah. What you're saying is that there's no evidence for the weight loss part.

Nicola: 5:35

Yes, and I also addressed that in my blog post, which is at noperiod.info/ALC. So, you know, certainly among the people that have taken it, sort of, for the purpose of possibly helping with HA recovery. You know, there's no weight loss that comes in that's associated with taking it, you know? So I think that that's just a myth and, it sells things and people like to buy things that might make them lose weight. So there you go. So I think really it's quite supportive of the hypothalamus. There's some suggestion that it might block, it, either increase or block dopamine release. I don't remember which one it is, but it's supportive of the hypothalamus. It might also be useful for increasing luteal phase. I don't know, but certainly the hypothalamus is one of the drivers of the luteal phase. Luteal phase being the time between when you ovulate and get your period. So, you know, that's another thing that people could try if they do have a short luteal phase after getting their period back. Flaxseed sort of comes from my research about seed cycling, which is another thing that's often recommended by a natural class or you just kind of like read about it on the web and it sounds cool. It's like hormone balance. That's a term I hate. Like, what does it actually mean to have balanced hormones? Like, They're never supposed to be balanced. I mean, if by balanced you mean equal, no. You're supposed to have different hormones at different times, particularly as somebody, you know, who's having a menstrual cycle or supposed to have a menstrual cycle. You know, sometimes your estrogen's supposed to be low, sometimes it's supposed to be high, sometimes your progesterone's supposed to be high. Like, what does hormonal balance mean?

Florence: 7:06

But I guess hormone cascade doesn't sound as good

Nicola: 7:12

yeah.

Florence: 7:13

because there's a sense of, they work a bit like a domino, right? This one goes up and then this one goes down and then, but I guess, yeah, the balance thing sounds a lot better to sell

Nicola: 7:24

so, but it doesn't actually have any meaning.

Florence: 7:26

Yeah, it's, it's the same as, during the pandemic, people were like, Oh, boost your immune system. And you had so many experts saying, what does that even mean? Like we can't boost anything in our immune system. Our immune system is there and works. We can't actually influence it with supplements. Yeah.

Nicola: 7:47

So anyway, the seed cycling idea is that you take, I don't even remember which seeds you take at which point in your cycle, but it's sometimes you take maybe flax seed and pumpkin seed for the first two weeks of your cycle, and then you take sesame seed and. whatever the other one is for the second two weeks. And if you don't have a cycle, then you're supposed to do it with the phase of the moon, which I was always like, what? Like that's way too much work. And there is no evidence. You look at the research and nobody does this on and off kind of thing. Like everybody who's doing research is using one supplement for months on end because that's how you see effect. So seed cycling is a waste of time. It's way too stressful, not worth it. So of those four seeds, the one that seemed to be the most likely to be beneficial for period recovery was flax seed. Even that is sort of like, there's one study that shows that it increases luteal phase length. It's not something that's really looked at, but I figure, you know, it's a good way to add some more energy into your diet. We know that energy helps you get your period back. And there's, you know, Obviously, so much scientific evidence for that. So, you know, and then maybe the particular types of fats that are in flaxseed are helpful. Maybe not. But you know, it's just mostly it's another way to get in some more energy, maybe beneficial for period recovery. Certainly only eating flaxseed is not going to get your period back. Only taking A. L. C. is not going to get your period back. It has in conjunction with actually working on recovery. Hi, Michael.

Florence: 9:25

That was my husband coming back from Abu Dhabi. Yeah, I mean, I think it's interesting because I always like to think of the risk and benefit, you know what I mean? It's one of those things. Yes. It's maybe not super heavily proven that it has an impact, but there's also not a lot of risk in taking it. And it's not super complicated. As you said, like the whole seed cycling thing, it really feels like, Oh my God, that would be such a headache to deal with. Where am I? Why is the moon? And what? So just adding a bit of flaxseed when you drink a smoothie, it has a bit of a nutty flavor. It's not too bad if you like that kind of flavor. But again, like if you really hate it, like don't force yourself

Nicola: 10:07

Oh yeah, absolutely. Yes. Yeah. Also there are lots of other studies of flaxseed for other medical indications suggesting that maybe it's helpful for those. So, you know, overall it seems like it has a pretty good risk benefit profile. So, all right, so let's leave that. So, there are a bunch of supplements that are sort of recommended with the idea of increasing estrogen or increasing progesterone or one of my clients just came to me and said that she was told to take tribulus terrestris Which increases testosterone maybe I mean again, all of these things are maybes. I think the problem with all of those is that all of those hormones are sort of following hormones, they're not leading hormones. So, when you have hypothalamic amenorrhea, the problem is that your hypothalamus is not sending the appropriate signals to the rest of your hormonal system. Taking more estrogen, taking more progesterone, taking more testosterone, which I guess the idea is that testosterone is converted to estradiol, so it raises the estrogen. I'm not even really sure why that was recommended. Those aren't solving the underlying problem. And they also might, if they do raise your estrogen or progesterone levels enough, then they could potentially suppress your hypothalamus because then your body thinks Oh, I'm in the luteal phase and so therefore I don't need FSH and LH. So we know that when you're in your luteal phase, estrogen and progesterone are nice and high, great for bone density building, great for your heart, but also that suppresses FSH and LH. So your FSH and LH, if you have them drawn during your luteal phase are actually quite low. Same thing if you're taking hormone replacement therapy or if you're on birth control. So all of those things are actually suppressing FSH and LH. the FSH and LH, maybe at the hypothalamic level, maybe at the pituitary level, but that's sort of the opposite of what we want to do. So, a lot of people have recommended Vitex, which is also called Chase Tree or Monk's Pepper. I don't recommend that because there are some indications that it can increase your progesterone, which is fine if that's what you need, but that's not what you need for HA recovery. So save your money, don't bother. And I think it's really important when you're thinking about taking a supplement, to try and understand what the rationale is for taking it. You know, like, there's another one that was talked about in the support group was people apparently recommend beef liver capsules or beef organ capsules. And I suppose there are some good nutrients in there, maybe, like there's amino acids or whatever, but nothing to do with your hypothalamus. So, I mean, You know, unless you're eating enough capsules to make up the calories that you need, there's going to be a ton of capsules. You know, it's not something that's going to be helpful for HA and recovery. I mean, it's not going to hurt if you want to take those. Sure, go, go ahead. But it's not something that you need to take, you should take. It's not something that's going to impact your recovery in any way, shape, or form, basically.

Florence: 13:08

And I think it's interesting how we see those fads happening, right? The seed cycling was quite, popular and then it kind of suddenly appears everywhere. Suddenly everybody's going to tell you how to do seed cycling and what it allowed for them to experience and all of that. And then suddenly, that beef liver thing didn't yet get to Europe, but I'm pretty sure it's going to come. And you're like, yes, of course I get that organ meats would maybe give you some, as you say, some nutrients or some benefits that maybe you don't get And obviously it's not very common anymore to eat organ meat. So it's easier to take it as a capsule, but it's one of those things like. You really see it's a bit like dieting, right? It just comes in waves of like, suddenly everybody wants to try that. And then the celery juice is the same thing, right? Suddenly everybody was having celery juice in the morning. Now it completely disappeared. We don't hear about celery juice anymore. So I think it's really important to also try and understand, as you say, like really, why am I doing this? Why am I attracted to this? Is it because I've seen it everywhere? Or is it really because there might be a benefit? So that's why we wanted to do this mini episode on this.

Nicola: 14:19

Yes. Yes. And then there are other supplements like vitamins and minerals. Some of those can be beneficial, particularly if you have low bone density, for example, you really do want to make sure that you're getting the, you know, an adequate amount of calcium. Things that can be helpful as well to go along with the calcium are vitamin D, vitamin K, vitamin as Americans would say, that's one of my leftover words from growing up in South Africa, boron, three milligrams a day can potentially be helpful for bone density as well. So, you know, again, but that's not to do with HA recovery. That's to do with coordinating your bone density. So like, again, know what you're taking a supplement for, what, what the mechanism is, do a little bit of reading about it. Oh, the, the other thing about the beef liver thing is you don't actually know what you're getting. I mean, so I looked at a couple of studies on PubMed. I went to just see, is there any research that supports these capsules and getting your period back? And there's not much, but there are a couple of places where people were looking at labeling and if the labeling meeting FDA requirements and, Not really. And also there was another group that did an mRNA analysis of what was in the capsules and mostly it was beef. There was some liver, but it's like unless you're very familiar with the company that's making these supplements, like honestly, some people are just in it to make money and they don't, you know, so caveat emptor, as they say.

Florence: 15:46

Supplements, this is also, I guess why someone like you who really bases their work on evidence is really not recommending that much, definitely not selling any. I mean, we're never going to sell you stuff that we make money out of, because that would be really unethical, but, I find that we tend to forget that supplements is a market that is not regulated. And, so we do this episode also to remind you of this. And I'm so glad you remembered to talk about this, that we do not always know what is in them and it can also be harmful. So if we don't really know what's in them or how they're really made then are we really getting what we want, but also could we get stuff that we could react to without knowing about it?

Nicola: 16:34

yeah. That's another point that I often make is that, there are a lot of supplements that are sort of like 20 different Chinese herbs. A, the dosing of any one of them is going to be so minimal that is it really going to do anything? B, you know, no studies on the interactions of all these different things and possibly any other medications that you're taking so particularly those supplements that are not just one ingredient but multiple ingredients I really tend to recommend against those I mean like adrenal support or hypothalamic support or any of that As I was preparing for this episode. I also just googled like supplements for your hypothalamus. And they're like, you can take pig hypothalamus if you want to. I mean, again, supposedly pig hypothalamus, but like, what's the point? Like how is ingesting hypothalamic tissue into your your esophagus and get all degraded? Like, how is that actually going to help your hypothalamus? Like it's just all get broken up into, Fatty acids and glucose and, you know, whatever. I mean, it's just so that, that kind of thing also just seems a little bit, someone's making a lot of money off it, but is it actually valuable? I'm, I don't think so. And the last point I want to make is that with any of these supplements, like really try and do things one at a time. So you can actually assess like, am I feeling better? Am I feeling worse? Am I noticing no difference? Or, if there's something you've been taking for a while, try stopping it, see how you feel. I think it's really important. We all have different reactions to all sorts of different medications based on, the way that it's processed in our liver, in our body, how all our different systems are interacting with each other, the receptors, the receptor binding proteins, like, All of that kind of stuff. We're all different. So, even if something works for somebody else, you need to try it for your own body and your own self. So, yeah.

Florence: 18:35

That was great. Thank you much, Nicola, for taking time and looking into all these crazy different supplements I didn't even know about. And, just a kind reminder. when I was recovering, we didn't take anything at all. We didn't know about any of those. And, it wasn't such a big deal. So really the core of your recovery is still the All In method. And, that's really where you need to put a lot of energy and efforts. So that will be it for today, I guess.

Nicola: 19:04

Oh, I just have one other thing I wanted to add. Wanted to share from the support group. So, apparently there's this company called Elix that is all the rage these days. And so one of the women in my support group went there just to see like, what do we tell her? So she said her symptom was thirst and it came back with, this is the best supplement for you based on your chin and your z and your whatever and oh, give us 40 a month for it. How about drink more?

Florence: 19:31

And it's cold water.

Nicola: 19:32

Yeah, comes out of your tap for free.

Florence: 19:38

So funny.

Nicola: 19:39

on that note, lovely to see you and

Florence: 19:41

Lovely to see you too. And, we will see you in two weeks. Thanks, Nicola. Bye.

19:51

One thing that always strikes me is how different each person's all in journey is. As I often say, there are many paths to HA and many paths out of it. Your journey is unique. That is so true. If you need more support on your journey, you should definitely start with NoPeriodNowWhat, which you can get at noperiod. info. com. And Florence and I both work with people on different aspects of period recovery and so much more. If you'd like more personalized advice and attention, you can go to noperiod. info slash appointments to schedule a time to speak with me on fixing issues underlying missing periods, blood work, diagnosis, and lots more. or beyondbodyimage. com to work with me on the fear of weight gain and making peace with food exercise in your body. I also take care of the new French version of No Period Now What through the Instagram account je underscore livre. We also have joined clients and online support groups so you can access both our domains of expertise and get the physical and mental help you deserve to put an end to disordered eating once and for all. If you enjoyed this podcast and found it helpful, please subscribe and drop us a review to help more people find it. Also, join our online recovery community at noperiod. info slash support in English and noperiod. info slash communique in French and let us know how All In is going for you. All In is not just about period recovery, it's about getting your life back. See you in two weeks!